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Thursday, January 1, 2015

Take time every day to slather your favorite lotion all over your body, especially on your legs, hands, and feet. It doesn't have to cost a fortune. Drugstores sell many moisturizers for under $10. Splurging? Try massage. Along with relaxing your muscles and helping your circulation, it feels good. Studies show it can boost mood and improve self-esteem for people with MS.

If you have a significant other, friend, or relative with multiple sclerosis(MS), you might know about some of the physical problems that can come with the disease. But chances are, that’s only part of what your loved one deals with.

MS can cause invisible symptoms that can be tricky to talk about.

Here are five common problems that many people with MS face, though they might never tell you.

“I can’t stand it when people say, 'I’m tired, too.'"

For people with MS, fatigue is a regular part of life. Trouble is, “lots of people think that just means I’m tired,” says Ann Pietrangelo, a 55-year-old MS Foundation ambassador and writer who lives in Williamsburg, VA. “They’ll say, 'Oh, yeah, I know exactly what you mean -- I didn’t get enough sleep last night.' They don’t understand that a nap or good night’s sleep is not going to fix the exhaustion that comes with MS.”

While your loved one might feel fine sometimes, “it’s not uncommon for a person with MS to wake up and take a shower, and that’s about all they can do for the day,” says Karen Blitz-Shabbir, DO. She's the director of the North Shore/LIJ MS Care Center in Long Island, NY.

Even if their physical energy is up, “brain fog can cause mental fatigue, which makes it hard to get a lot done,” says Matthew McCoyd, MD. He's a neurologist at Loyola University Medical Center in Illinois.

Be supportive by saying “I’m sorry” or “Can I help you?” rather than sharing how tired you’re feeling.

“I wish you’d ask my spouse if she needs help.”

Something people with MS hear a lot is, “Let me know if you need help.” While specific offers, like “I’m going to the grocery store. Is there anything I can pick up for you?” can be helpful, consider asking the person’s partner, too.

Some 90% of patients with relapsing-remitting multiple sclerosis had no clinical relapses or signs of progression 3 years after receiving high-dose immunosuppression followed by autologous hematopoietic stem-cell transplant, researchers reported.

Interim results from 25 participants in the closely watched HALT-MS trial yielded a progression-free survival rate of 90.9% (95% CI 73.7%-97.1%) and a relapse-free survival rate of 86.3% (95% CIO 68.1%-94.5%), according to Richard A. Nash, MD, of the Colorado Blood Institute in Denver, and colleagues.

Most serious adverse events occurred within the first month after starting the myeloablative regimen, but nine patients experienced grade 3 events and one suffered a grade 4 event after year two of the study, Nash and colleagues reported online in JAMA Neurology. Another patient died during study year three from MS progression-related causes, they noted.

These late adverse effects led two independent experts, writing an accompanying editorial, to caution that hematopoietic stem-cell transplant remained unproven as an MS treatment.

"The jury is still out regarding the appropriateness and indications of HCT [hematopoietic cell transplant] for MS," wrote M. Mateo Paz Soldan, MD, PhD, of the University of Utah in Salt Lake City, and Brian G.Weinshenker, MD, of the Mayo Clinic in Rochester, Minn.

In addition to their concerns about the treatment's safety, the editorialists also questioned the extent to which the desired "immune reset" had actually been achieved, given that new and/or enlarging brain lesions continued to develop and clinical relapses occurred in some patients more than 3 years post-transplant.

"This study raises concern that those endpoints [freedom from clinical or radiological relapse] have not been adequately achieved," Paz Soldan and Weinshenker wrote.

But Nash and colleagues portrayed the results as a win for HCT, albeit with caveats about the study duration so far and the need for additional confirmatory trials. The study did not have a control group.

Study Details

The investigators noted that HCT has been tested in MS before, with ambiguous results, probably because patients tended to have advanced disease and therefore continued to show functional declines related to non-inflammatory neurodegeneration. HCT is not regenerative, but rather is intended to terminate the immunologically mediated demyelination that sets the stage for, but is not directly causative of the subsequent neuronal and functional loss.

SARASOTA, Fla. -- Choking is the third leading cause of accidental death in the over 65 population and the forth leading cause of accidental death in the United States.

For those with Multiple Sclerosis in particular, including early on in the course of the disease, dysphagia (difficulty swallowing), pulmonary dysfunction and muscle weakness arise. When these impairments occur early on most are unaware that there is a problem.

Dysphagia may cause the individual to cough after drinking liquids or choke when eating certain foods, especially those with a crumbly texture.

Whether you live with MS or are a caregiver for someone living with it, you can empathize with the array of swallowing challenges and the subsequent psychological toll that it creates for all.

Unfortunately, if the swallowing challenges turn into a choking episode, there is a chance the individual may aspirate, or inhale fluid or solids into the upper respiratory tract, resulting in aspiration pneumonia.

Finally, there is a device to help with this life-threatening issue: LifeVac; a revolutionary new product designed to remove an object from an obstructed airway.

The LifeVac is a non-powered single patient portable suction apparatus developed for resuscitating a choking victim when standard ACLS protocol has failed. The negative pressure generated by the force of the suction is 3 times greater than the highest recorded choke pressure. The duration of suction is minimal so LifeVac is safe and effective.

LIFEVAC IS SAFE

LifeVac is designed with a patented valve to prevent any air from exiting through the mask. This patented designed valve prevents air from pushing food or objects downward. This creates a one-way suction to remove the lodged food or object.

No prescription required.

LifeVac can be purchased online at www.LifeVac.net and at these Medical Department
Stores in Florida:

Monday, December 29, 2014

The Editorial Board of Neurology Today, a journal of the American Academy of Neurology, selected a study about cognition and MS among the most important studies published in 2014, suggesting the need for earlier rehabilitation for people with MS who experience cognitive problems. Read more from Neurology Today.

Investigators have just released the interim results of a five-year study of high-dose immunosuppressive therapy (HDIT) and hematopoietic stem cell therapy in 24 individuals with multiple sclerosis. After three years, most of the participants showed improvements in neurological function and sustained remission of active relapsing-remitting MS (RRMS).

The new JAMA Neurology article reports the findings of the Hematopoietic Cell Transplantation for Relapsing-Remitting Multiple Sclerosis (HALT-MS) study. Basically, the idea is that use of HDIT supported by autologous (use of a patient’s own cells) hematopoietic stem cell infusions (transplantation) will stop disease activity in individuals who have poor prognosis RRMS.

In this study, autologous hematopoietic cell transplantation involved removing CD34 stem cells and storing them while the individuals were treated with high-dose immunosuppressive therapy; that is, the chemotherapy drugs carmustine, cytarabine, etoposide, and melphalan. The stored hematopoietic stem cells, which are responsible for the formation of blood, were then transfused into the patient’s bloodstream

At the three-year evaluation point, the authors found that, without the use of any maintenance therapy:

Overall rate of event-free survival (i.e., survival without loss of neurologic function, new lesions seen on imaging, or clinical relapse) was 78.4 percent

Progression-free survival was 90.9 percent

Clinical relapse-free survival was 86.3 percent

Quality of life, functional scores, and neurological disability all also improved

The authors concluded that the combination of high-dose immunosuppressive therapy and hematopoietic stem cell transplantation “may represent a potential therapeutic option for patients with MS in whom conventional immunotherapy fails.” However, they also emphasized that “longer follow-up is needed to determine the durability of the response.”

This combination therapeutic approach is not without side effects. The most common adverse events were cytopenias (64%), infections (56%), gastrointestinal disorders (36%), metabolism disorders (32%), and nervous system issues (24%), such as headache.

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SYMPTOMS of MS

In multiple sclerosis , damage to the myelin in the central nervous system (CNS), and to the nerve fibers themselves, interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption of nerve signals produces the primary symptoms of MS, which vary depending on where the damage has occurred.

Over the course of the disease, some symptoms will come and go, while others may be more lasting.

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